A Top Down look at Blockchain - the Federal Perspective
HIMSS 19 Blockchain Symposium
Steve Posnack, Executive Director, Office of Technology, ONC
ONC “In a Nutshell”
ONC focuses on the Administration’s
priority of building a health system that
delivers value and maximizes the
promise of health IT.
We use our levers to accelerate
individuals’ ability to access and send
their health information so they can
shop for and coordinate care.
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ONC’S Mission
Improve the health and well-being of
individuals and communities through
the use of technology and health
information that is accessible when
and where it matters most.
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Session objectives
Outline the work of HHS and the role they play in technology decisions
Demonstrate how HHS looks at new technologies, and how technologies like
blockchain become part of the discussion
Discuss HHS’s current blockchain strategy and the expected near and medium
term impacts of those efforts
Review key considerations for the private sector as they design impactful
solutions
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ONC -- A Focus on 21
st
Century Cures
» Interoperability Efforts:
Promote standardized, application programming interfaces (APIs)
Combat information blocking
Accelerate data exchange between disparate health information
networks.
Promote patient access to health information
Administer the Health IT Advisory Committee (HITAC)
» Provider Burden Efforts:
Develop strategy with the Centers for Medicare and Medicaid
Services (CMS) to reduce administrative and reporting burden
among clinicians.
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ONC is focused on the 21
st
Century Cures Acts priorities of increasing nationwide interoperability and
reducing clinician burden.
What kind of blockchain do you want to be?
Public
Private
Permissioned
Permission-less
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How “off the chain” are we?
HHS
» Last year HHS launched Accelerate, which uses distributed-ledger technology, machine learning and artificial
intelligence to deliver real-time information on pricing and terms and conditions from across HHS. It is
designed to facilitate the Federal Acquisition Lifecycle.
GSA
» https://www.gsa.gov/technology/government-it-initiatives/emerging-citizen-technology/blockchain
NIST IR8202
» https://www.nist.gov/publications/blockchain-technology-overview
Congress
» https://www.congressionalblockchaincaucus.com/
Other work/interest across many other Departments
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Overview of ONC engagement
Blockchain Challenge (Summer 2016)
Use of Blockchain in Healthcare and Research Workshop (September 2016)
The Blockchain in Healthcare Code-A-Thon (March 2017)
Blockchain Technology and Healthcare Webinar (February 2018)
Oh the Places Data Goes: Health Data Provenance” Challenge (March 2018)
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"Use of Blockchain in Health IT and Health-Related Research" Ideation Challenge
15 Whitepaper winners
https://oncprojectracking.healthit.gov/wiki/display/TechLabI/Blockchain+Challenge+on+ONC
+Tech+Lab
Smaller sample invited to speak at NIST-ONC workshop
Winning papers themes included:
» Algorithms, Privacy, and Data
» Claims processing
» Medication reconciliation
» Improving electronic health information exchange and patient engagement
» Secure records storage
» Health research and consent management
» Medicaid applicants
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Blockchain in Healthcare Code-A-Thon
Co-hosted by ONC and the Chamber of Digital Commerce
March 14 -15, 2017 at Georgetown
University
Solicited distributed ledger projects that
addressed one or more of the following:
» Identity Management and APIs
» Metadata Tagging and Policy Expression
» Data Aggregation and Linkage
Interoperability in Action Webinar Series #4
Blockchain in Healthcare
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Keynote speaker Justin Herman of General Services Administration (GSA)
Blockchain NISTer update presented by the National Institute of Standards and
Technology (NIST).
Presentations from the four 1
st
round winners of ONCs Health Data Provenance
Challenge in which participants proposed solutions to real-world obstacles for provenance
in clinical care. Of the four 1
st
round winners, three proposed solutions based on the use
of blockchain technology.
HHS Roundtable and Q & A session.
https://oncprojectracking.healthit.gov/wiki/display/TechLabI/2018+Interoperability+in+Ac
tion+Webinar+Series+%234
Potential Healthcare Blockchain Use Cases 2+ years later
Identity Management (Identity, authentication, authorization,) and credential verification
Access Control and Consent
Auditing
New and Improve Workflows
» IRB Clinical Trial approval
» Patient sharing of data
» Supply Chain -- Drug dispensing, monitoring
» Tracking and access to Internet of Things
» Hospital Stays
» Medicaid Eligibility
» Claims process and payment automation
Off chain record location and viewing
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Federal Government Use Cases
Blockchain use cases other agencies are exploring touch many parts and processes of an organization,
including:
» Financial management
» Procurement
» IT asset and supply chain management
» Smart contracts
» Patents, Trademarks Copyrights, Royalties
» Government-issued credentials like visas, passports, SSN and birth certificates
» Federal personnel workforce data
» Appropriated funds
» Federal assistance and foreign aid delivery
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@ONC_HealthIT @HHSONC
THANKS!